New research led by investigators at Massachusetts General Hospital has revealed what the SARS-CoV-2 does once it enters a person’s airways. To analyze SARS-CoV-2 at the tissue level, the researchers examined autopsied material from 24 patients who succumbed to COVID-19. They used a method called RNA in situ hybridization to visualize the actual SARS-CoV-2 virus in human lung specimens. The analysis revealed two phases of infection in patients with severe COVID-19 pneumonia.
The early phase is defined by high levels of virus in the lungs that trigger patients’ cells to express genes involved with the interferon pathway, a critical part of the immune response. In the later phase, the virus is no longer present, but the damage to the lungs is too severe for recovery. The researchers also found that there is surprisingly very little viral replication in the lungs, which suggests that the virus is mostly replicating in the nasal passages and then dropping into the lungs, where it can cause pneumonia and other complications.
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